Swedish national guidelines on urothelial carcinoma: 2024 update on advanced and metastatic disease

Objective: To overview and summarise the Swedish National Guidelines on Urothelial Carcinoma 2024. Methods: A narrative review of the updated guidelines was performed, highlighting new treatment recommendations for advanced and metastasized disease.  Results: Compared to the previous guideline...

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Main Authors: Anders Ullén, Firas Aljabery, Pär Dahlman, Karin Falkman, Truls Gårdmark, Tomas Jerlström, Susanna Holst, Sofia Kjellström, Anna-Karin Lind, Dimitrios Papantoniou, Jonas Stenlund, Viveka Ströck, Karin Söderkvist, Helena Thulin, Elin Trägårdh, Ingrida Verbiene, Jonas Wallström, Elisabeth Öfverholm, Fredrik Liedberg
Format: Article
Language:English
Published: Medical journals sweden AB 2025-03-01
Series:Scandinavian Journal of Urology
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Online Access:https://medicaljournalssweden.se/SJU/article/view/43236
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author Anders Ullén
Firas Aljabery
Pär Dahlman
Karin Falkman
Truls Gårdmark
Tomas Jerlström
Susanna Holst
Sofia Kjellström
Anna-Karin Lind
Dimitrios Papantoniou
Jonas Stenlund
Viveka Ströck
Karin Söderkvist
Helena Thulin
Elin Trägårdh
Ingrida Verbiene
Jonas Wallström
Elisabeth Öfverholm
Fredrik Liedberg
author_facet Anders Ullén
Firas Aljabery
Pär Dahlman
Karin Falkman
Truls Gårdmark
Tomas Jerlström
Susanna Holst
Sofia Kjellström
Anna-Karin Lind
Dimitrios Papantoniou
Jonas Stenlund
Viveka Ströck
Karin Söderkvist
Helena Thulin
Elin Trägårdh
Ingrida Verbiene
Jonas Wallström
Elisabeth Öfverholm
Fredrik Liedberg
author_sort Anders Ullén
collection DOAJ
description Objective: To overview and summarise the Swedish National Guidelines on Urothelial Carcinoma 2024. Methods: A narrative review of the updated guidelines was performed, highlighting new treatment recommendations for advanced and metastasized disease.  Results: Compared to the previous guideline version, the current update includes recommendations for standardised radiological reporting when urothelial carcinomas are detected at CT-urography (CTU), to early identify locally advanced patients and accelerate the care pathway for these patients. The Swedish guidelines apply a more structured and liberal recommendation for the use of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography in patients with locally advanced urothelial carcinomas compared to the EAU-guidelines and recommend such examinations prior to transurethral resection. Improved outcomes for radical cystectomy in Sweden after centralised cystectomy care have led to a recommendation for performing more than six nephroureterectomies (NUs) per year for upper tract urothelial carcinomas (UTUC)-based associations with decreased use of invasive diagnostic modalities and better survival outcomes. Additionally, updated recommendations regarding adjuvant systemic therapies for muscle-invasive disease have been included. Whilst awaiting national regulatory approval for enfortumab vedotin/pembrolizumab, the present guideline version aligns with EAU-guidelines by endorsing cisplatin-gemcitabine-nivolumab as a new first-line treatment option in cisplatin-fit patients with unresectable or metastatic urothelial carcinoma. Conclusions: The current version of the Swedish national guidelines on urothelial carcinoma introduces standardised reporting at CTU to facilitate early identification of advanced disease, includes recommendations for centralisation of NU for UTUC and updated recommendations for adjuvant systemic treatment of muscle-invasive disease and endorses cisplatin-gemcitabine-nivolumab as a new first-line treatment option for non-resectable locally advanced and metastatic disease.
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spelling doaj-art-70662aa07b984bf6ac61f47e46af6e932025-08-20T03:47:32ZengMedical journals sweden ABScandinavian Journal of Urology2168-18132025-03-016010.2340/sju.v60.43236Swedish national guidelines on urothelial carcinoma: 2024 update on advanced and metastatic diseaseAnders Ullén0Firas Aljabery1Pär Dahlman2Karin Falkman3Truls Gårdmark4Tomas Jerlström5Susanna Holst6Sofia Kjellström7Anna-Karin Lind8Dimitrios Papantoniou9Jonas Stenlund10Viveka Ströck11Karin Söderkvist12Helena Thulin13Elin Trägårdh14Ingrida Verbiene15Jonas Wallström16Elisabeth Öfverholm17Fredrik Liedberg18Department of Pelvic Cancer, Genitourinary Oncology and Urology Unit, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden; Department of Oncology and Pathology, Karolinska Institute, Stockholm, SwedenDepartment of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, SwedenDepartment of Radiology, Uppsala Akademiska Hospital, Uppsala, SwedenDepartment of Urology, Södersjukhuset, Stockholm, SwedenDepartment of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, SwedenDepartment of Urology, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, SwedenDepartment of Medical Imaging and Physiology, Skåne University Hospital, Malmö, SwedenDepartment of Oncology, Skåne University Hospital, Malmö, SwedenDepartment of Urology, Skåne University Hospital, Malmö, Sweden; Institution of Translational Medicine, Lund University, Malmö, SwedenDepartment of Oncology, Ryhov County Hospital, Jönköping, SwedenDepartment of Urology, Umeå University, Umeå, SwedenDepartment of Urology, Sahlgrenska University Hospital, Göteborg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, SwedenDepartment of Diagnostics and Intervention, Onkology, Umeå University, Umeå, SwedenDepartment of Pelvic Cancer, Genitourinary Oncology and Urology Unit, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden; Department of Oncology and Pathology, Karolinska Institute, Stockholm, SwedenDepartment of Medical Imaging and Physiology, Skåne University Hospital, Malmö, Sweden; Institution of Translational Medicine, Lund University, Malmö, SwedenDepartment of Oncology, Uppsala Akademiska Hospital, Uppsala, SwedenDepartment of Radiology, Sahlgrenska University Hospital, Göteborg, SwedenDepartment of Oncology, Sahlgrenska University Hospital, Göteborg, SwedenDepartment of Urology, Skåne University Hospital, Malmö, Sweden; Institution of Translational Medicine, Lund University, Malmö, Sweden Objective: To overview and summarise the Swedish National Guidelines on Urothelial Carcinoma 2024. Methods: A narrative review of the updated guidelines was performed, highlighting new treatment recommendations for advanced and metastasized disease.  Results: Compared to the previous guideline version, the current update includes recommendations for standardised radiological reporting when urothelial carcinomas are detected at CT-urography (CTU), to early identify locally advanced patients and accelerate the care pathway for these patients. The Swedish guidelines apply a more structured and liberal recommendation for the use of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography in patients with locally advanced urothelial carcinomas compared to the EAU-guidelines and recommend such examinations prior to transurethral resection. Improved outcomes for radical cystectomy in Sweden after centralised cystectomy care have led to a recommendation for performing more than six nephroureterectomies (NUs) per year for upper tract urothelial carcinomas (UTUC)-based associations with decreased use of invasive diagnostic modalities and better survival outcomes. Additionally, updated recommendations regarding adjuvant systemic therapies for muscle-invasive disease have been included. Whilst awaiting national regulatory approval for enfortumab vedotin/pembrolizumab, the present guideline version aligns with EAU-guidelines by endorsing cisplatin-gemcitabine-nivolumab as a new first-line treatment option in cisplatin-fit patients with unresectable or metastatic urothelial carcinoma. Conclusions: The current version of the Swedish national guidelines on urothelial carcinoma introduces standardised reporting at CTU to facilitate early identification of advanced disease, includes recommendations for centralisation of NU for UTUC and updated recommendations for adjuvant systemic treatment of muscle-invasive disease and endorses cisplatin-gemcitabine-nivolumab as a new first-line treatment option for non-resectable locally advanced and metastatic disease. https://medicaljournalssweden.se/SJU/article/view/43236Bladder cancerguidelinesadvancedmetastatic
spellingShingle Anders Ullén
Firas Aljabery
Pär Dahlman
Karin Falkman
Truls Gårdmark
Tomas Jerlström
Susanna Holst
Sofia Kjellström
Anna-Karin Lind
Dimitrios Papantoniou
Jonas Stenlund
Viveka Ströck
Karin Söderkvist
Helena Thulin
Elin Trägårdh
Ingrida Verbiene
Jonas Wallström
Elisabeth Öfverholm
Fredrik Liedberg
Swedish national guidelines on urothelial carcinoma: 2024 update on advanced and metastatic disease
Scandinavian Journal of Urology
Bladder cancer
guidelines
advanced
metastatic
title Swedish national guidelines on urothelial carcinoma: 2024 update on advanced and metastatic disease
title_full Swedish national guidelines on urothelial carcinoma: 2024 update on advanced and metastatic disease
title_fullStr Swedish national guidelines on urothelial carcinoma: 2024 update on advanced and metastatic disease
title_full_unstemmed Swedish national guidelines on urothelial carcinoma: 2024 update on advanced and metastatic disease
title_short Swedish national guidelines on urothelial carcinoma: 2024 update on advanced and metastatic disease
title_sort swedish national guidelines on urothelial carcinoma 2024 update on advanced and metastatic disease
topic Bladder cancer
guidelines
advanced
metastatic
url https://medicaljournalssweden.se/SJU/article/view/43236
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